JACQUELINE BRAUNWORTH (NPI# 1649665936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649665936 |
| Entity Type | Individual |
| Full Name | JACQUELINE BRAUNWORTH |
| Credential | PA-C |
| Practice Address |
68 Division St Derby CT 06418-1447 |
| Practice Telephone | 2037326802 |
| Practice Fax Number | 2037326792 |
| Mailing Telephone | 2037326802 |
| Mailing Fax Number | 2037326792 |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2017-10-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 003273 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
003273 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 1649665936 | 05 |
| Street Address |
68 DIVISION ST |
| City | DERBY |
| State | CT |
| Zip Code | 06418-1447 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528592417 | Medexpress Urgent Care Connecticut, P.C. | Emergency Medicine | 68 Division St, Derby, CT 06418-1447 | 2017-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942839105 | Fnu Prinkiya | Student in an Organized Health Care Education/Training Program | Griffin Hospital. 130 Division St, Derby, CT 06418 | 2020-04-08 |
| 1942837935 | Ivanshi A Gondalia | Student in an Organized Health Care Education/Training Program | Griffin Hospital, 130 Division St, Derby, CT 06418 | 2020-03-27 |
| 1972168094 | Pir Saad | Student in an Organized Health Care Education/Training Program | C/o Margie Bliga, Department of Medical Education, Griffin Hospital, 130 Division St, Derby, CT 06418 | 2019-05-03 |
| 1295398899 | Ahtsham Yousaf Chaudhary | Student in an Organized Health Care Education/Training Program | 130 Division St, Griffin Hospital, Derby, CT 06418 | 2019-04-18 |
| 1477016376 | Rabia Usman | Student in an Organized Health Care Education/Training Program | 130 Division St. Griffin Hospital, Derby, CT 06418 | 2019-04-09 |
| 1932661428 | Meshal Qaiser | Student in an Organized Health Care Education/Training Program | 130 Division Street Griffin Hospital, Derby, CT 06418 | 2019-04-03 |
| 1275027666 | Victoria Anne Hodge Enquist | Social Worker | 241 Seymour Avenue, Griffin Hospital Iop, Seymour, CT 06418 | 2018-06-19 |
| 1811485758 | Nimeshayan Varatharajah | Student in an Organized Health Care Education/Training Program | Griffin Hospital, 130 Division St., Derby, CT 06418 | 2018-04-26 |
| 1851889836 | Pete Prashamsa Shenoy | Student in an Organized Health Care Education/Training Program | Griffin Hospital (dpt of Graduate Medical Education), 130 Division St., Derby, CT 06418 | 2018-04-25 |
| 1639696594 | Samantha Leigh Bassett | Counselor | 90 Sodom Lane, Derby, CT 06418 | 2017-08-23 |
| Find all providers in zip 06418 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184110660 | Astrid B Garza Posadas | Physician Assistant | 435 New Haven Ave Ste 2, Derby, CT 06418-2534 | 2018-07-08 |
| 1053638296 | Anjana Hemraj Porwal | Physician Assistant | 6970 Erie Rd Ste A, Derby, NY 14047-9591 | 2010-04-28 |
| 1396836714 | Debra Sullivan | Physician Assistant | 130 Divsiion Street, Derby, CT 06418 | 2006-09-28 |
| 1548713621 | Jocelyn Batista Mendes | Physician Assistant | 300 Seymour Ave Ste 102, Derby, CT 06418-1343 | 2016-07-26 |
| 1528310067 | Brenton Richard Dempsey | Physician Assistant | 130 Division St, Derby, CT 06418-1326 | 2012-10-08 |
| 1235443516 | Jenny L. Bronson | Physician Assistant | 130 Division St, Emergency Department, Derby, CT 06418-1326 | 2010-07-29 |
| 1144321902 | Malissa Kay Paxton | Physician Assistant | 606 Mulberry Rd, Derby, KS 67037-3532 | 2006-09-26 |
| 1124129911 | Edwin Lysle Price | Physician Assistant | 606 Mulberry Rd, Derby, KS 67037-3532 | 2006-09-26 |
| 1558380253 | David Maffei | Physician Assistant | 130 Division St, Derby, CT 06418-1326 | 2006-07-19 |
| 1912923889 | Mark Taafel | Physician Assistant | 130 Division St, Derby, CT 06418-1326 | 2006-07-14 |
| Find all providers in DERBY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.